ED Coding and Reimbursement Alert

Question: A patient arrived at our ED with inflammation of the lungs, and was experiencing pain while breathing. He also had dry cough, chills, and a fever. The patient keeps and raises parakeets and pigeons as a hobby. After chest X-rays, the ED physician diagnosed the patient with bird fancier’s lung. How should we report this?

Pennsylvania Subscriber

Answer: Bird fancier’s lung (J67.2) falls under the J67.- (Hypersensitivity pneumonitis due to organic dust) code family. The parent code, J67.-, carries a symbol that indicates an additional 4th character is required for proper reporting.

While the patient is diagnosed with bird fancier’s lung in this scenario, you will find several other specific diagnoses in this code family that are the result of environmental factors and fall under the hypersensitivity pneumonitis classification. These codes include:

• J67.0 (Farmer’s lung)
• J67.1 (Bagassosis)
• J67.3 (Suberosis), which is also known as Corkworker’s disease
• J67.4 (Maltworker’s lung)
• J67.6 (Maple-bark-stripper’s lung)
• J67.8 (Hypersensitivity pneumonitis due to other organic dusts)

The last ICD-10-CM code of that list, J67.8, also carries additional descriptors, such as Cheese-washer’s lung, Coffee-worker’s lung, Fish-meal worker’s lung, and Furrier’s lung, which the physician could document in their report.

However, if the provider diagnosed the patient with hypersensitivity pneumonitis, but the documentation didn’t appear to specify a concrete reason as to why, then you would instead choose J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust).